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General NPI Number Information
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NPI Number | 1821282179
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Entity Type | Organization
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Legal Business Name | RANDALL PHYSICAL THERAPY
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 2175 N ALMA SCHOOL RD STE A106
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City | CHANDLER
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State | AZ
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Zip | 85224-2802
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Country | US
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Telephone | 480-730-5656
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Fax |
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Provider Business Mailing Address
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Address Line | 2175 N ALMA SCHOOL RD STE A106
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City | CHANDLER
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State | AZ
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Zip | 85224-2802
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Country | US
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Telephone | 480-730-5656
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD RANDALL
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Credential |
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Telephone | 480-730-5656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 569
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License Number State | AZ
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